Sympathetic nerve damage as a potential cause of lymphoedema after axillary dissection for breast cancer
Identifieur interne : 000302 ( PascalFrancis/Checkpoint ); précédent : 000301; suivant : 000303Sympathetic nerve damage as a potential cause of lymphoedema after axillary dissection for breast cancer
Auteurs : T. M. Bennett Britton [Royaume-Uni] ; S. M. L. Wallace [Royaume-Uni] ; I. B. Wilkinson [Royaume-Uni] ; Peter Mortimer (dermatologue) [Royaume-Uni] ; A. M. Peters [Royaume-Uni] ; A. D. Purushotham [Royaume-Uni]Source :
- British journal of surgery [ 0007-1323 ] ; 2009.
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Abstract
Background: The physiological disturbances leading to lymphoedema after breast cancer surgery are poorly understood. Damage to sympathetic nerves during axillary lymph node dissection (ALND), leading to increased capillary fluid filtration, was investigated as a possible contributory factor. Methods: The integrity of the upper limb sympathetic nervous system was tested in 36 patients before, and 3 and 12 months after ALND. Forearm vascular resistance (FVR), calculated from forearm blood flow and mean systemic arterial pressure, was measured before and after exposure to lower-body negative pressure. Forearm venous compliance was measured using 99mTc-labelled autologous erythrocytes and radionuclide plethysmography before and after cold water immersion of the feet. Results: There were clear changes in FVR and venous compliance in response to sympathetic stimulation but no differences attributable to surgery or between the nine patients who developed lymphoedema and the 27 who did not; nor were there differences between the two arms. There was a trend towards lower preoperative FVR in patients who developed lymphoedema. Conclusion: Lymphoedema is not the result of sympathetic nerve damage sustained during ALND. Preoperative FVR may help predict who will get lymphoedema following this surgery.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Sympathetic nerve damage as a potential cause of lymphoedema after axillary dissection for breast cancer</title><author><name sortKey="Bennett Britton, T M" sort="Bennett Britton, T M" uniqKey="Bennett Britton T" first="T. M." last="Bennett Britton">T. M. Bennett Britton</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Research Oncology, King's College London and Guy's and St Thomas' NHS Foundation Trust, Bermondsey Wing, Guy's Hospital</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Wallace, S M L" sort="Wallace, S M L" uniqKey="Wallace S" first="S. M. L." last="Wallace">S. M. L. Wallace</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Clinical Pharmacology, Vascular Research Clinics, Addenbrooke's Centre for Clinical Investigation, Cambridge University Hospitals NHS Foundation Trust</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Cambridge</wicri:noRegion></affiliation></author><author><name sortKey="Wilkinson, I B" sort="Wilkinson, I B" uniqKey="Wilkinson I" first="I. B." last="Wilkinson">I. B. Wilkinson</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Clinical Pharmacology, Vascular Research Clinics, Addenbrooke's Centre for Clinical Investigation, Cambridge University Hospitals NHS Foundation Trust</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Cambridge</wicri:noRegion></affiliation></author><author><name sortKey="Mortimer, P S" sort="Mortimer, P S" uniqKey="Mortimer P" first="P. S." last="Mortimer">Peter Mortimer (dermatologue)</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Cardiac and Vascular Sciences (Dermatology), St George's Medical School</s1><s2>London</s2><s3>GBR</s3><sZ>4 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">Université de Londres</orgName></affiliation></author><author><name sortKey="Peters, A M" sort="Peters, A M" uniqKey="Peters A" first="A. M." last="Peters">A. M. Peters</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Nuclear Medicine, Royal Sussex County Hospital</s1><s2>Brighton</s2><s3>GBR</s3><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Brighton</wicri:noRegion></affiliation></author><author><name sortKey="Purushotham, A D" sort="Purushotham, A D" uniqKey="Purushotham A" first="A. D." last="Purushotham">A. D. Purushotham</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Research Oncology, King's College London and Guy's and St Thomas' NHS Foundation Trust, Bermondsey Wing, Guy's Hospital</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0314468</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0314468 INIST</idno><idno type="RBID">Pascal:09-0314468</idno><idno type="wicri:Area/PascalFrancis/Corpus">000319</idno><idno type="wicri:Area/PascalFrancis/Curation">000639</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000302</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000302</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Sympathetic nerve damage as a potential cause of lymphoedema after axillary dissection for breast cancer</title><author><name sortKey="Bennett Britton, T M" sort="Bennett Britton, T M" uniqKey="Bennett Britton T" first="T. M." last="Bennett Britton">T. M. Bennett Britton</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Research Oncology, King's College London and Guy's and St Thomas' NHS Foundation Trust, Bermondsey Wing, Guy's Hospital</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Wallace, S M L" sort="Wallace, S M L" uniqKey="Wallace S" first="S. M. L." last="Wallace">S. M. L. Wallace</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Clinical Pharmacology, Vascular Research Clinics, Addenbrooke's Centre for Clinical Investigation, Cambridge University Hospitals NHS Foundation Trust</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Cambridge</wicri:noRegion></affiliation></author><author><name sortKey="Wilkinson, I B" sort="Wilkinson, I B" uniqKey="Wilkinson I" first="I. B." last="Wilkinson">I. B. Wilkinson</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Clinical Pharmacology, Vascular Research Clinics, Addenbrooke's Centre for Clinical Investigation, Cambridge University Hospitals NHS Foundation Trust</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Cambridge</wicri:noRegion></affiliation></author><author><name sortKey="Mortimer, P S" sort="Mortimer, P S" uniqKey="Mortimer P" first="P. S." last="Mortimer">Peter Mortimer (dermatologue)</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Cardiac and Vascular Sciences (Dermatology), St George's Medical School</s1><s2>London</s2><s3>GBR</s3><sZ>4 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">Université de Londres</orgName></affiliation></author><author><name sortKey="Peters, A M" sort="Peters, A M" uniqKey="Peters A" first="A. M." last="Peters">A. M. Peters</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Nuclear Medicine, Royal Sussex County Hospital</s1><s2>Brighton</s2><s3>GBR</s3><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Brighton</wicri:noRegion></affiliation></author><author><name sortKey="Purushotham, A D" sort="Purushotham, A D" uniqKey="Purushotham A" first="A. D." last="Purushotham">A. D. Purushotham</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Research Oncology, King's College London and Guy's and St Thomas' NHS Foundation Trust, Bermondsey Wing, Guy's Hospital</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><series><title level="j" type="main">British journal of surgery</title><title level="j" type="abbreviated">Br. j. surg.</title><idno type="ISSN">0007-1323</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">British journal of surgery</title><title level="j" type="abbreviated">Br. j. surg.</title><idno type="ISSN">0007-1323</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Axillary</term><term>Breast cancer</term><term>Cause</term><term>Dissection</term><term>Lesion</term><term>Lymphedema</term><term>Malignant tumor</term><term>Mammary gland</term><term>Medicine</term><term>Surgery</term><term>Sympathetic nerve</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Lymphoedème</term><term>Nerf sympathique</term><term>Lésion</term><term>Tumeur maligne</term><term>Cause</term><term>Axillaire</term><term>Cancer du sein</term><term>Dissection</term><term>Glande mammaire</term><term>Médecine</term><term>Chirurgie</term><term>Traitement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Médecine</term><term>Chirurgie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: The physiological disturbances leading to lymphoedema after breast cancer surgery are poorly understood. Damage to sympathetic nerves during axillary lymph node dissection (ALND), leading to increased capillary fluid filtration, was investigated as a possible contributory factor. Methods: The integrity of the upper limb sympathetic nervous system was tested in 36 patients before, and 3 and 12 months after ALND. Forearm vascular resistance (FVR), calculated from forearm blood flow and mean systemic arterial pressure, was measured before and after exposure to lower-body negative pressure. Forearm venous compliance was measured using <sup>99m</sup>Tc-labelled autologous erythrocytes and radionuclide plethysmography before and after cold water immersion of the feet. Results: There were clear changes in FVR and venous compliance in response to sympathetic stimulation but no differences attributable to surgery or between the nine patients who developed lymphoedema and the 27 who did not; nor were there differences between the two arms. There was a trend towards lower preoperative FVR in patients who developed lymphoedema. Conclusion: Lymphoedema is not the result of sympathetic nerve damage sustained during ALND. Preoperative FVR may help predict who will get lymphoedema following this surgery.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0007-1323</s0></fA01><fA02 i1="01"><s0>BJSUAM</s0></fA02><fA03 i2="1"><s0>Br. j. surg.</s0></fA03><fA05><s2>96</s2></fA05><fA06><s2>8</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Sympathetic nerve damage as a potential cause of lymphoedema after axillary dissection for breast cancer</s1></fA08><fA11 i1="01" i2="1"><s1>BENNETT BRITTON (T. M.)</s1></fA11><fA11 i1="02" i2="1"><s1>WALLACE (S. M. L.)</s1></fA11><fA11 i1="03" i2="1"><s1>WILKINSON (I. B.)</s1></fA11><fA11 i1="04" i2="1"><s1>MORTIMER (P. S.)</s1></fA11><fA11 i1="05" i2="1"><s1>PETERS (A. M.)</s1></fA11><fA11 i1="06" i2="1"><s1>PURUSHOTHAM (A. D.)</s1></fA11><fA14 i1="01"><s1>Department of Research Oncology, King's College London and Guy's and St Thomas' NHS Foundation Trust, Bermondsey Wing, Guy's Hospital</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Clinical Pharmacology, Vascular Research Clinics, Addenbrooke's Centre for Clinical Investigation, Cambridge University Hospitals NHS Foundation Trust</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Cardiac and Vascular Sciences (Dermatology), St George's Medical School</s1><s2>London</s2><s3>GBR</s3><sZ>4 aut.</sZ></fA14><fA14 i1="04"><s1>Department of Nuclear Medicine, Royal Sussex County Hospital</s1><s2>Brighton</s2><s3>GBR</s3><sZ>5 aut.</sZ></fA14><fA20><s1>865-869</s1></fA20><fA21><s1>2009</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>5039</s2><s5>354000187257890060</s5></fA43><fA44><s0>0000</s0><s1>© 2009 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>13 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>09-0314468</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>British journal of surgery</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>Background: The physiological disturbances leading to lymphoedema after breast cancer surgery are poorly understood. Damage to sympathetic nerves during axillary lymph node dissection (ALND), leading to increased capillary fluid filtration, was investigated as a possible contributory factor. Methods: The integrity of the upper limb sympathetic nervous system was tested in 36 patients before, and 3 and 12 months after ALND. Forearm vascular resistance (FVR), calculated from forearm blood flow and mean systemic arterial pressure, was measured before and after exposure to lower-body negative pressure. Forearm venous compliance was measured using <sup>99m</sup>Tc-labelled autologous erythrocytes and radionuclide plethysmography before and after cold water immersion of the feet. Results: There were clear changes in FVR and venous compliance in response to sympathetic stimulation but no differences attributable to surgery or between the nine patients who developed lymphoedema and the 27 who did not; nor were there differences between the two arms. There was a trend towards lower preoperative FVR in patients who developed lymphoedema. Conclusion: Lymphoedema is not the result of sympathetic nerve damage sustained during ALND. Preoperative FVR may help predict who will get lymphoedema following this surgery.</s0></fC01><fC02 i1="01" i2="X"><s0>002B01</s0></fC02><fC02 i1="02" i2="X"><s0>002B12B04</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Lymphoedème</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Lymphedema</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Linfedema</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Nerf sympathique</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Sympathetic nerve</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Nervio simpático</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Lésion</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Lesion</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Lesión</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Tumeur maligne</s0><s2>NM</s2><s5>04</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Malignant tumor</s0><s2>NM</s2><s5>04</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Tumor maligno</s0><s2>NM</s2><s5>04</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Cause</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Cause</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Causa</s0><s5>05</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Axillaire</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Axillary</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Axilar</s0><s5>06</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Cancer du sein</s0><s2>NM</s2><s5>07</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Breast cancer</s0><s2>NM</s2><s5>07</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Cáncer del pecho</s0><s2>NM</s2><s5>07</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Dissection</s0><s5>08</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Dissection</s0><s5>08</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Disección</s0><s5>08</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Glande mammaire</s0><s5>09</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Mammary gland</s0><s5>09</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Glándula mamaria</s0><s5>09</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Médecine</s0><s5>11</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Medicine</s0><s5>11</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Medicina</s0><s5>11</s5></fC03><fC03 i1="11" i2="X" l="FRE"><s0>Chirurgie</s0><s5>12</s5></fC03><fC03 i1="11" i2="X" l="ENG"><s0>Surgery</s0><s5>12</s5></fC03><fC03 i1="11" i2="X" l="SPA"><s0>Cirugía</s0><s5>12</s5></fC03><fC03 i1="12" i2="X" l="FRE"><s0>Traitement</s0><s5>25</s5></fC03><fC03 i1="12" i2="X" l="ENG"><s0>Treatment</s0><s5>25</s5></fC03><fC03 i1="12" i2="X" l="SPA"><s0>Tratamiento</s0><s5>25</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Cancer</s0><s2>NM</s2></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cancer</s0><s2>NM</s2></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Cáncer</s0><s2>NM</s2></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Pathologie de l'appareil circulatoire</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Cardiovascular disease</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0><s5>37</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Pathologie des vaisseaux lymphatiques</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Lymphatic vessel disease</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Linfático patología</s0><s5>38</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Pathologie de la glande mammaire</s0><s2>NM</s2><s5>39</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Mammary gland diseases</s0><s2>NM</s2><s5>39</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Glándula mamaria patología</s0><s2>NM</s2><s5>39</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Pathologie du sein</s0><s2>NM</s2><s5>40</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Breast disease</s0><s2>NM</s2><s5>40</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Seno patología</s0><s2>NM</s2><s5>40</s5></fC07><fN21><s1>229</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement><orgName><li>Université de Londres</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Bennett Britton, T M" sort="Bennett Britton, T M" uniqKey="Bennett Britton T" first="T. M." last="Bennett Britton">T. M. Bennett Britton</name></region><name sortKey="Mortimer, P S" sort="Mortimer, P S" uniqKey="Mortimer P" first="P. S." last="Mortimer">Peter Mortimer (dermatologue)</name><name sortKey="Peters, A M" sort="Peters, A M" uniqKey="Peters A" first="A. M." last="Peters">A. M. Peters</name><name sortKey="Purushotham, A D" sort="Purushotham, A D" uniqKey="Purushotham A" first="A. D." last="Purushotham">A. D. Purushotham</name><name sortKey="Wallace, S M L" sort="Wallace, S M L" uniqKey="Wallace S" first="S. M. L." last="Wallace">S. M. L. Wallace</name><name sortKey="Wilkinson, I B" sort="Wilkinson, I B" uniqKey="Wilkinson I" first="I. B." last="Wilkinson">I. B. Wilkinson</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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